Mizunashi K, Takaya K, Sato H, Mori S, Abe K, Furukawa Y
Second Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
Clin Investig. 1994 Jun;72(6):448-50. doi: 10.1007/BF00180519.
Parathyroid crisis occurring in primary hyperparathyroidism is characterized by extremely high circulating levels of parathyroid hormone and acute onset of severe hypercalcemia. We describe a 62-year-old woman with parathyroid crisis probably due to an intratumoral hemorrhage. Renal dysfunction reduced the effectiveness of preoperative management and continued to deteriorate for 5 days after parathyroidectomy. The normalization of serum calcium after parathyroidectomy delayed and it took 6 days. Maintenance of renal function is important for pre- and postoperative courses of the present case. The rapid decrease in serum parathyroid hormone after parathyroidectomy was followed by a rapid and transient (about fivefold) increase in serum alkaline phosphatase with peak value on the 10th postoperative day. This indicated that reversal phase from bone resorption (accelerated by parathyroid hormone) to bone formation lasted about 10 days under the conditions of the present case.
原发性甲状旁腺功能亢进症中发生的甲状旁腺危象的特征是循环中甲状旁腺激素水平极高且严重高钙血症急性发作。我们描述了一名62岁的患有甲状旁腺危象的女性，可能是由于肿瘤内出血所致。肾功能不全降低了术前管理的效果，并且在甲状旁腺切除术后持续恶化了5天。甲状旁腺切除术后血清钙的正常化延迟，耗时6天。维持肾功能对本病例的术前和术后病程很重要。甲状旁腺切除术后血清甲状旁腺激素迅速下降，随后血清碱性磷酸酶迅速且短暂（约五倍）升高，在术后第10天达到峰值。这表明在本病例的情况下，从骨吸收（由甲状旁腺激素加速）到骨形成的逆转阶段持续约10天。
